Family doctors are being told to try to talk women out of having Caesareans and very strong painkillers during birth to save the NHS money. New guidelines drawn up for GPs urge them to encourage women to have natural labours with as little medical help as possible. But for many women the prospect of giving birth without the painkillers is unthinkable. And critics have said the move has been made without any thought for the women themselves. The guidelines also remind doctors to tell women to consider having their babies outside hospital in midwife-run units or in their own homes.

Another preview of what is coming here if ObamaCare is not repealed. This is a War on Women. The guideline about shoveling women into midwives will result in women dying from childbirth as they do not have immediate access to the proper medical facilities if things go wrong.

Right on. But for the favored constituencies like people wanting abortions, sex change operations, treatment for ailments resulting from drug abuse or promiscuous lifestyles, nobody will be trying to talk them out of making choices that could save healthcare $.

Oh the irony. With my second child, I managed to find a rather famous midwife to the Amish community. As an RN working in a related area, I wanted a midwife, not a “deliver you on my schedule” doctor. Talk about being ostracized! Then I got pregnant in a Commonwealth country with socialized medicine. I was over 40 so I was “high risk.” In a city of 3 million people, I could only find 2 OBs. My option for care was pretty much only a midwife. They also didn’t do regular pap smears, breast exams, etc., and no doubt we’ll see lots of “studies” released now about how we don’t really need them.

I am sure that the NHS also has “guidelines” for the treatment of high risk newborns ....neonatal intensive care is expensive you know... and many infants that would be in a NICU in the US and survive are likely simply allowed to die in the UK because treating them would be too expensive.

It's quite another for the government to force a woman to go natural whether she wants to or not.

My mother was one of the first of the Grantly Dick-Read 'natural childbirth' mothers in this country. She had to shop around to find an OB who would agree to let her deliver without drugs.

My OB for my first baby had been a very gung-ho natural childbirth advocate as a young doctor, but with experience he concluded that it had to be the mother's informed choice. We talked it over and decided to give it a try. Everything went swimmingly; it was a rapid, uneventful, and reasonably comfortable delivery. The bonus was that I strolled out of recovery on my own two feet, and was happily cruising around the next morning when the other ladies who had been in labor at the same time were nursing epidural headaches.

But I had a choice. And if somebody is pressured into delivering without drugs, and without the necessary Lamaze training, they will have a hideous and painful experience, because fear = tension = pain.

A baby below a certain birthweight, or below a certain gestational age, or who dies within 48 hours, is not even counted as a "live birth".

THAT is why the U.S. child mortality statistics look so bad, compared with Britain and the rest of Europe. They do not count the high-risk newborns as births at all. Easy to look good if you cook the numbers.

Nothing has changed since I had my child at a London Hospital over 12 years ago. Back then they were pushing for woman to give birth at home with a mid wife. If there were any “problems” you could call an ambulance or drive to the hospital.

Complications such as post-partum infection ('childbed fever') were the real killers. And doctors who weren't real clear on the germ theory of disease and didn't practice rigorous sanitation were the No. 1 problem.

There's a great old popular medical book from the 20s by a doctor - can't recall his name at the moment. But he noted that the patients at the lying-in hospital in Jena in the 18th century had a mortality rate of one hundred percent.

My great-great-great grandfather was a prolific sort, he had 17 children by two wives. His first wife didn't die in childbirth - she died of typhoid fever.

“I am sure that the NHS also has guidelines for the treatment of high risk newborns ....neonatal intensive care is expensive you know... and many infants that would be in a NICU in the US and survive are likely simply allowed to die in the UK because treating them would be too expensive.”

I worked over 14+ years in NICU. I have a nephew that was in an NICU in another city. When I read his chart, I had virtually no hope and had to try to say encouraging things to my sister. He’s a Cornell University graduate with honors, and married now. Yeah, they had a really expensive medical bill, but I truly shudder at the thought of what Obamacare will do to NICU care. The U.S. was the world leader in treatment and care. Socialized medicine is not a spark for seeking breakthroughs in care or new forms of treatment. I was blessed to work in the top hospital in the world and saw many, many breakthroughs and changes. That can be kissed good-bye with Obamacare.

Epidurals ARE more expensive, and take more skill to administer. However, they have big advantages: in childbirth, an epidural does not anesthetize the newborn, who is born lively, and usually starts breathing on his own. The mother also recovers more rapidly.

I (a male) had an epidural for major surgery, because my doctor recommended it. Even then, I had to make arrangements for it beforehand: I had to call the chief or surgery at the hospital, and ask for an epidural. I explained why I wanted it, and he emphatically agreed, but in that hospital the anesthesiologist is assigned only at the last minute, and not all of them do epidurals. Usually only the Board-certified can do it. The chief promised me that he would appoint one of the qualified anesthesiologists, or else he would step in and take my case himself. And so it was that I had an epidural, and awoke from surgery with no nausea, feeling weak, but very hungry (which is to be expected, because they generally make the patient fast beforehand). I got out of the hospital in the shortest possible time.

I am not sure that I would want an epidural in England, because their healthcare system is rickety. Improperly administered, an epidural can be dangerous.

Actually, if I were in England and needed medical care, I would get back to the States as quickly as possible!

I try to talk women out of epidurals because every woman I know who ever had one during delivery was complaining about back pain ten, twenty and thirty years later.

Back pain happens for a number of reasons. I had an epidural once, but I'm pretty certain the back pain is from osteoarthritis exacerbated by scoliosis. The only way to control the pain is to exercise.

27
posted on 08/31/2012 7:23:54 AM PDT
by exDemMom
(Now that I've finally accepted that I'm living a bad hair life, I'm more at peace with the world.)

Personally I found out that being pregnant for 10 months, being put in medically induced labor only when my body began to enter preeclampsia, laboring for 24 hours until I began bleeding out of every pore, and then having a dramatic life threatening caesarean - was the worst of all possible worlds

except the baby and I both lived by some grace of God

Army medicine- Gotta love it - good preview of obamacare

The chief at the army hospital then didn't believe in epidurals - so they weren't offered

They didn't even give me a bullet to bite- no firearms training card in my pocket (ha ha)

“I try to talk women out of epidurals because every woman I know who ever had one during delivery was complaining about back pain ten, twenty and thirty years later.”

Have you ever been through labor and delivery personally? My first child was an emergency C-section after 33 hours of labor. My second was an attempted, failed V-Back. For my third, my doctor offered the option of a V-Back and my response was unequivocally, “no!” The minimal back pain I’ve experienced over the years was nothing compared to what I went through during labor and delivery. I’d take the back pain any day, because I could take an aspirin or an ibuprofen and get relief.
Beats the heck out of hours in labor so painful you think you’re in a Nazi prison camp being treated by Dr. Mengele. My 2 cents as an RN who’s worked closely with L&D.

I’ve had two children with epidurals, and I could kiss the anesthesiologists who gave them to me. They didn’t hurt going in, the kids didn’t hurt coming out, and I’ve had no side effects at all. For modesty’s sake, I won’t go into some of the complications from the birth of the first, but I’ll just say it would have been unbearable without that epidural.

Now the old-fashioned caudal blocks from my mother’s day did cause lingering back pain.

“Obviously I can never walk in your shoes. All Im saying is that all the women in my life who have had them tell me they had ongoing pain at the site for years, and they would never have one again.”

They may be the exception, but not necessarily the rule. I wouldn’t trade the couple years of occasional, intermittent pain I endured for the alternative. I ended up during my first delivery being told that because I’d chosen natural child birth, that, no, I couldn’t get an epidural because there was no anesthesiologist available...at least not until it became an emergency C-section. As an RN, working so long in the area, I know there is a good chance I wouldn’t have needed a C-section if I’d had an epidural. I’ve always tried to present an even, informed, balanced education to my patients, with a risks-benefits analysis. My experience after my first was worth a bottle of ibuprofen. I consider myself blessed though, because I heard the horror stories from co-workers about their episiotomies and virtual inability to have normal intercourse again.

What age group are the women? I think the meds used and probably the insertion techniques for epidurals have changed over the years. Like anything else, there are benefits AND risks. I’ve had — let me count — 5? Only from one do I remember any lingering discomfort at the insertion site, lasted perhaps six months. Never had headaches or anything from it.

Things relating to pregnancy and childbirth (epidurals, breasfeeding, etc.) too often bring out such militant responses. I’ve had doctors who never heard of an intervention they didn’t love and advocate. I’ve heard women who think if you don’t squat in the woods to give birth, you’re “not natural.” I say bah-humbug to both. Give women objective, unbiased information and let them decide without guilt either way, for heaven’s sake! Having given birth both with and without epidural, I can say delivery is a whole lot more ... pleasant (ha) WITH. On the other hand, I liked the mobility and less invasive nature of birth without it, too.

Sounds like you had a really rough ride. Both my mom and I had episiotomies with no ill effects -- sure beats an uncontrolled tear.

My doc (and I made sure to engage an old hand who had been delivering babies for 40 years) was prepared for any contingencies such as a long and difficult labor or bad presentation. But the family are sturdy Scotch-Irish farming stock on both sides, and have always had lots of babies without any difficulty. I can't remember anyone having any trouble at all, except my maternal grandmother, who was a bacteriologist and nurse and probably scared herself half to death thinking of all the anomalies she had seen in her career . . . . but she perforce had a natural childbirth because it was 1924 . . . .

“Both my mom and I had episiotomies with no ill effects — sure beats an uncontrolled tear.”

I used to do a very visual argument about an uncontrolled tear with new nurses. I’m glad you weren’t one of the many women who could never enjoy sex again. My nursing instructors were old broads who lived through WW11. I think they worked hard to teach common sense. Epesiotomy- take a piece of cloth and try to tear it. Good luck. Cut it and then try to tear it. Nuff said.

I try to talk women out of epidurals because every woman I know who ever had one during delivery was complaining about back pain ten, twenty and thirty years later. This surprises me. As the mother of 4, I can tell you that my back is fine.

The NHS has its problems, but it is not rickety or third rate or third world or a hellhole. The NHS by and large is a damn good system that works most of the time. If you were in England, you would be I am sure pleasantly surprised at the standard of care. I wish Americans would at least actually experience it and not go on second or third hand opinions.

I'll go with my doc's opinion - a smoothly contoured episiotomy is better than a ragged tear, and if the tear decides to go midline on its own and extends all the way through the perineum, you are in so much trouble. And certainly a snip is indicated in a very rapid labor, as I had.

My doc was a feisty old character (may he rest in peace), a red-headed Irishman with a temper to match. But he knew his business, and he was chief of OB/GYN surgery at the best hospital in Atlanta.

A separate WHO Bulletin in 2008 noted that registration of stillbirths, live births, and neonatal deaths is done differently in countries where abortion is legal compared with countries where abortion is uncommon or illegal, and these discrepancies generate substantial differences in infant-mortality rates. Jan Richardus showed that the perinatal mortality rate can vary by 50% depending on which definition is used, and Wilco Graafmans reported that terminology differences alone among Belgium, Denmark, Finland, France, Germany, Greece, the Netherlands, Norway, Portugal, Spain, Sweden, and the U.K.  highly developed countries with substantially different infant-mortality rates  caused rates to vary by 14 to 40 percent, and generated a false reduction in reported infant-mortality rates of up to 17 percent.

I have worked for the NHS and know the way we compile our statistics. I confirmed this in a personal email to a major UK natal charity, as a few months ago, as there was a similar thread on RightNation, of which I am also a member. And I wanted to confirm that I was correct. I reposted the email verbatim there, I will try and find it if I can. RN has a habit though of wiping old threads, but I will try and find it.

The NR is particularly bad when writing about the UK. It gets simple facts wrong a lot.

I contacted Bliss, the premier British charity that helps care for premature and sick babies and their families

‘Dear Sir/Madam,

I have a query about infant mortality that I hope you can help me with.

I am curious as to the definition/methodology of British infant mortality. For example, the United States counts all births as live if they show any sign of life, regardless of prematurity or size. But I have been unable to find any information on whether Britain’s definition is the same, similar or different.

I would be grateful if you could answer said question or point me to information that would answer my question.’

‘Dear *****

In regards to the definition of live births the British definition is the same as the Americans’ in that it counts all births as live if they show any sign of life, regardless of prematurity and size.

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